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Total joint replacement in inhibitor-positive haemophilia:Long-term outcome analysis in fifteen patients
Total joint replacement in inhibitor-positive haemophilia:Long-term outcome analysis in fifteen patients
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摘要：
AIM To collect data from joint replacement in inhibitor patients,evaluate haemostatic and patient outcomes,and analyse the costs.METHODS We report our 21-year,single-centre cumulative experience of 15 joint arthroplasties in six inhibitor patients.RESULTS Two low responder inhibitor patients were in the early days treated with FVIII,whereas bypassing agents were used in the rest of the high responder patients.The primary haemostatic outcome was good in 8/15,fair in 4/15 and poor in 3/15 operations.The overall patient outcome,including joint health and patient satisfaction,was good in 10/15,fair 4/15 and poor in 1/15.No deep infections were observed.Cost analysis was most beneficial in low responders and in two immune-tolerized,high responder patients.In all cases,factor replacement comprised the main treatment costs.CONCLUSION Our experience supports the initial use of bypassing agents as well as preoperative immune-tolerance induction when possible.Despite the challenges of haemostasis and severe joint disease,total joint arthroplasty can reach a good outcome,even in inhibitor patients.The risk for deep infection might be smaller than previously reported.Individual planning,intense multidisciplinary teamwork and execution of operations should be centralised in a professional unit.
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研究主题发展历程
节点文献
HAEMOPHILIA
Joint
REPLACEMENT
INHIBITOR
COST
analysis
ARTHROPLASTY
研究起点
研究来源
研究分支
研究去脉
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期刊影响力
世界骨科杂志：英文版
主办单位：
百世登出版集团有限公司
出版周期：
月刊
ISSN：
2218-5836
CN：
开本：
出版地：
北京市朝阳区东四环中路62号楼远洋国际中
邮发代号：
创刊时间：
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出版文献量（篇）
404
总下载数（次）
1
总被引数（次）
0
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